晚期食管鳞癌一线XP方案化疗后卡培他滨维持治疗的临床疗效

Clinical effect of xeloda maintenance therapy after the first-line XP chemotherapy for advanced esophageal squamous cell carcinoma

目的:探讨晚期食管鳞癌一线XP方案(卡培他滨+顺铂)化疗后卡培他滨维持治疗的疗效及安全性。方法:选取晚期食管鳞癌一线XP方案化疗后疾病控制(完全缓解、部分缓解、疾病稳定)的患者60例,随机分为维持组和对照组,每组30例,维持组予以卡培他滨维持化疗,对照组仅行最佳支持治疗,观察两组的ORR、PFS、OS以及毒副反应。结果:维持治疗组ORR 26.7%,对照组ORR 6.7%(P=0.038);两组中位PFS分别为14.1个月、9.9个月(P=0.006),两组中位OS分别为23.8个月、17.9个月(P=0.020),均具有统计学差异;主要毒副反应为骨髓抑制、胃肠道反应、手足综合征,III级毒副反应发生率为6.7%。结论:晚期食管鳞癌一线XP方案化疗后卡培他滨的维持治疗,可以改善PFS以及OS,毒副反应可耐受,值得临床进一步研究。

Objective:To explore the curative effect and security of xeloda maintenance therapy after the first-line XP(xeloda+PDD)chemotherapy for advanced esophageal squamous cell carcinoma.Methods:Sixty patients who suffered from advanced esophageal squamous cell carcinoma and accepted disease control after the first-line XP chemotherapy(complete remission,somewhat remission,stable condition)were randomly divided into maintenance group and control group(30 cases in each group).Patients in maintenance group were treated with xeloda,while those in control group only received the best supportive treatment.Then,the ORR,PFS,OS,toxic and side effects in the two groups were observed.Results:The ORR was 26.7%in maintenance group and that in control group was 6.7%(P=0.038).The median PFS and OS in both groups were 14.1 vs 9.9 months(P=0.006)and 23.8 vs 17.9 months(P=0.020)respectively,both of which have statistical differences.The main toxic and side effect were bone marrow suppression,gastrointestinal reactions,hand-foot syndrome,and the incidence rate of grade III toxic and side effect was 6.7%.Conclusion:The xeloda maintenance therapy after first-line XP chemotherapy for advanced esophageal squamous cell carcinoma can improve both PFS and OS.Also,the toxin side effects are well tolerable,which is worth being further researched clinically.